Battling past depression: a mental health director’s story

Despite her expertise as an experienced mental health nurse and director, Mandy Stevens didn’t see her own depression coming. Mandy, who is speaking this week at our health policy summit, describes her story and the importance of talking about mental illness.

Blog post

Published: 01/03/2018

Author

Please note that views expressed in guest blogs on our website are the authors' own and do not necessarily reflect the views of the Nuffield Trust.

I can now see that depression crept up on me slowly and silently. Despite 30 years’ experience as a registered mental health nurse, I didn’t recognise, acknowledge or even really notice the range of symptoms I had been experiencing, or how they had been affecting me. It was only when I finally cried at work that I realised something was wrong.

At the time I was working as an executive director in a London mental health NHS trust. There wasn’t the obvious feeling of being extremely sad – there had just been a slow downhill trundle and loss of enjoyment in life. My range of symptoms included being overly self-critical and a loss of interest in things I usually enjoy. I was tired but not sleeping. Procrastinating and feeling like I was a failure.

Sudden deterioration

I was very surprised by the rapid decline in my mental health and how it affected every area of my life so quickly. I went from fully functioning as a director to being almost mute, constantly crying, unable to care for myself and actively wanting to kill myself in 10 days.

I was referred to the local crisis response team and assessed as needing admission to hospital for my own safety.

Hold on a minute, this couldn’t be happening to me. I had worked on a crisis response team, I had worked as a community psychiatric nurse for eight years. I was an expert in mental health – particularly depression and being suicidal. Or at least I thought I was, until I fell in to that hideous, deep, groggy, terrifying pit myself. I had never needed to use NHS mental health services before, having just had about three episodes of mild-to-moderate depression. Now this was getting rapidly out of control.

As a clinician I have been taught not to use the phrase “nervous breakdown”, as it is not a clinical diagnosis and is seen as outdated. But this is the most accurate description of what I experienced on the day of my admission. I was shattered inside, I had nothing left to give. I was completely broken.

Depression sucked the life and soul out of me – it took away everything I was. Within a week of admission I was almost unable to function at all, wringing my hands in despair and almost constantly crying. I lost all interest in myself and in my personal hygiene. I didn’t care about anything.

The suicidal thoughts were constantly at the front of my mind. I was so absorbed with my depression that I thought the only option I had was to kill myself. The depth, frequency and intensity of the suicidal thoughts were overwhelming – it seemed the only option I had.

Coming back to what I knew

However, this is where my clinical experience and professional knowledge kicked in. I knew from training, but mostly from seeing hundreds of patients fully recover from depression, that I would be 100% okay again. But depression is a liar. The depression was telling me I was a bad person, that there was no point in living anymore, that I was actually a burden and a nuisance to people around me. This was in complete contradiction to what I knew was the truth.

It was the firm knowledge of recovery and the wonderful care I received that stopped me from taking my own life. I kept saying to myself “just wait until after lunch and see how you feel” or “see how you feel after you’ve seen the psychologist tomorrow morning”. I kept bargaining with myself and buying time.

The care I received through the NHS was first class. The compassionate nurses, thoughtful and careful doctors, and an impressive array of multi-disciplinary team members were consistent, recovery focused, caring and just amazing.

My clinical experience informed my recovery plan – not just appointments and medication, but a whole-person approach. Mindfulness, gym, social life, managing stress and increasing social contact again. It was full of ups and downs and didn’t go smoothly, but throughout this time I was rock solid in my knowledge that I would be 100% me again. I was fully recovered nine months after admission, and back to full-time work a month later.

Let’s talk about it

My reflection now is that I am not proud that I have mental health problems, but I am certainly not embarrassed about it.

Stigma surrounding mental illness is alive and kicking. Initially I was slow to tell people as I felt too vulnerable. However, after I spoke so openly and publicly about my mental health I received nothing but support, love and kindness.

I also found that many people approached me to talk about their own experience too. The more we talk about our own mental health, the easier it is for others to start conversations about theirs.

Mandy Stevens is speaking at this week’s Nuffield Trust Health Policy Summit. A version of this blog was first published by the Guardian Healthcare Professionals Network, who are a media partner for the Summit.

Please note that views expressed in guest blogs on our website are the authors' own and do not necessarily reflect the views of the Nuffield Trust.